Ice vs. Heat

A common question that patients ask at Queen Street Chiropractic Centre is when is it appropriate to use ice, and when is it appropriate to use heat?

While every case is unique, and there are factors that can influence how to treat an injury, there are some general rule that can be followed.  These rules are dependent on which stage of injury the individual is currently experience. The stages are Acute, Sub-Acute and Chronic.


The acute phase of injury follows the initial cause of the injury.  This is the phase where the body is possibly still in shock, and is beginning the process of registering where and how much damage is present to the different structures of the body.  The Acute Phase may last from approximately 72 hours to up to a few weeks depending on the severity of the injury.  During the Acute Phase there may be significant swelling of the injured region, although this may not necessarily be the case.  In the Acute Phase of healing, ICE is the appropriate course of treatment to employ.

Specifically, the wisest course of action (aside from consulting your Chiropractor) is to employ RICE.

R- Rest

I – Ice

C – Compression (this refers to utilizing items such as bandages, tensers, braces etc.)

E – Elevation (typically elevating the affected region to facilitate reducing swelling.



The Sub-Acute Phase of healing is the transition from Acute to Chronic injuries, and this phase is often the time when patients are confused as to which modality to employ.  The Sub-Acute Phase is variable in length, ranging from several days to potentially several months depending on the severity of injury.  During this phase RICE or heat may be employed, and must be judged on a case-by-case basis.  In general, if there is still swelling present in this phase then RICE is the most appropriate option.  If there is no swelling present, then the individual may employ heat instead.

When using heat, it is vital to remember to combine the heat with moisture.  What does this mean?  NO HEATING PADS!  Heating pads feel great when they are on the affected region, however heat without moisture often puts the injured musculature into protective spasm and may prolong symptoms.  Instead of heating pads utilize either hot water bottles, bean bag hot packs etc.  These types of heat also produce a form of moisture and reduces spasm (and they are less expensive options as well). 



The last phase of injury is the Chronic Phase.  This phase covers long-term injuries, often with a time period measured in months or years.  Most injuries of this type tend to be present in individuals who have avoided treatment or “toughed it out” instead of dealing with the injury.  In this phase, it is more appropriate for the patient to use moist heat, as most of the affected structures have long-term damage and no swelling is present.


Remember that each case is different, and even the same individual may have several injuries that are in different Phases.